Healthcare Provider Details

I. General information

NPI: 1710819040
Provider Name (Legal Business Name): ASHLEY HASTY
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

189 PROFESSIONAL CT SE
CALHOUN GA
30701-7053
US

IV. Provider business mailing address

189 PROFESSIONAL CT SE
CALHOUN GA
30701-7053
US

V. Phone/Fax

Practice location:
  • Phone: 706-272-6000
  • Fax: 706-272-6000
Mailing address:
  • Phone: 706-272-6000
  • Fax: 706-272-6000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License NumberRN239645
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: